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Pro tect No. <br />Prooram No. <br />Function No <br />Service No. <br />Planning Unit <br />Permit No: <br />Project Title: !Bridge Inspection City of Tukwila <br />Project Location: Various location in the City of Tukwila <br />Project Type: Reimbursable Org: 5626 Division No: <br />KC Road Log <br />Number: <br />Related CIP <br />Project No: <br />PROJECT DESCRIPTION: <br />TASK <br />Inspection of 6 City owned bridges <br />55.02.08 <br />TASK DESCRIPTION: <br />Start Year: 2014 Start Date: 2/1/14 <br />Is this a multi- <br />year project - <br />Ves/No: <br />No <br />Estimated <br />year of final <br />completion: <br />12/31/2014 <br />2012: <br />Estimated project expenditures by year: <br />2014: $9,600.00 <br />2013: 2015: <br />Bridge Inspection <br />53,182.00 <br />UBIT Inspection on Bridge Tuk -05 and Tuk -21 <br />55.02.08 <br />Routine Inspections on Tuk -15, 17, 19, 20, 22 <br />UBIT Inspection <br />92,700.00 <br />Provide inspection reports to WSDOT and the city after completion of the inspections. <br />90.00.34 <br />Administration, Tech support, Report Prep, UBIT and driver <br />S3,000.00 <br />Equipment <br />5100.00 <br />Contingency <br />$618.00 <br />TOTAL: $9,600.00 <br />AIRS CUSTOMER NUMBER: 73- <br />BR: SR: <br />* * "* *REQUIRED FIELDS IF PROJECT IS REIMBURSABLE" * "* <br />11 <br />LABOR: <br />ER &R EQUIPMENT: <br />VENDOR EQUIPMENT: UBIT <br />RR FLAGGING: <br />CONTRACT: <br />TOTALS: <br />ESTIMATED: <br />96,182.00 <br />ACTUAL: <br />9100.00 <br />92,700.00 <br />9618.00 <br />$9,600.00 <br />$0.00 <br />Enter Customer Billing Information below <br />Customer Contact Name: Robin Tischmak, Senior Transportation Engineer <br />Customer Billing Company Name: City of Tukwila <br />Customer Billing Address No. 1: 6300 Southcenter Blvd. Suite 100 <br />Customer Billing Address No. 2: Tukwila, WA 98188 -2544 <br />Customer Contact Phone Number: 206 - 433 -0179 <br />(mom) *MIAOW) <br />Roads Project Mgr: !Margaret Hotwegner Roads PM Phone No: 206 -477 -3539 <br />OPEN SIGNATURES: <br />(REOUIRED) CLOSURE DATE:. <br />REOUESTOR: NAME DATE - <br />AUTHORIZER: NAME: DATE. <br />FIELO PROCESSING: NAME' DATE <br />FINANCE PROCESSING: NAME' DATE' <br />CLOSURE SIGNATURES: <br />REOUESTOR: NAME. <br />AUTHORIZER: NAME: <br />FIELD PROCESSING: NAME: <br />FINANCE PROCESSING: NAME: <br />(REQUIRED) CLOSURE PATE; <br />DATE <br />DATE. <br />DATE. <br />DATE <br />• • w <br />